Evaluation of technologies for identifying acute cardiac ischemia in emergency departments

Agency for Healthcare Research and Quality (AHRQ)
Record ID 32001000977
Authors' objectives:

Acute cardiac ischemia (ACI) includes unstable angina pectoris (UAP) and acute myocardial infarction (AMI) and is the leading cause of death in the United States. The rapid and accurate diagnosis of ACI has substantial clinical and economic benefits. This report updates a 1997 report that evaluated the diagnostic technologies for identifying patients with ACI in the emergency department (ED), where most patients with ACI enter the health care system.

Authors' recomendations: - A diverse array of technologies with varying degrees of diagnostic accuracy is available for use in general or selected patient populations to diagnose ACI in the ED. - No single technology is able to identify all ACI patients and at the same time avoid hospitalizing many patients without ACI. - Most studies evaluated patients with AMI rather than ACI. - Research on the diagnosis of ACI in the ED is characterized by great heterogeneity among studies because of the large number of variables that can be studied. This heterogeneity has resulted in fragmented evidence that is not easily synthesized into a coherent whole. - Some technologies (e.g., echocardiography, sestamibi imaging, exercise ECG) remain underevaluated, and little research has been done on the value of sequential testing or on test combinations. - The number of studies on the clinical impact of these technologies is inadequate. - The quality of reporting by studies in this area needs to be improved.
Authors' methods: Systematic review
Project Status: Completed
Year Published: 2001
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: United States
MeSH Terms
  • Emergency Medical Services
  • Emergency Service, Hospital
  • Myocardial Ischemia
Organisation Name: Agency for Healthcare Research and Quality
Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
Contact Name: martin.erlichman@ahrq.hhs.gov
Contact Email: martin.erlichman@ahrq.hhs.gov
Copyright: Agency for Healthcare Research and Quality (AHRQ)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.